Cervical Spondylosis: An Overview

Cervical spondylosis, also known as cervical osteoarthritis or arthritis of the neck, is a condition characterized by age-related wear and tear of the spinal disks in the neck.[1][2] This degenerative process can lead to various changes in the cervical spine, including the dehydration and shrinkage of spinal disks, the development of bone spurs (osteophytes), and the stiffening of ligaments.[1] While it is a common condition, affecting over 85% of people over the age of 60, many individuals with cervical spondylosis experience no symptoms.[1][2]

Symptoms of Cervical Spondylosis

When symptoms do occur, they can range from mild to severe and may develop gradually or appear suddenly.

Early Symptoms:

• Neck pain and stiffness are the most common initial symptoms.[1][3]

• Some individuals may experience a clicking, popping, or grinding sound when moving their neck.[3][4]

• Headaches, often starting at the back of the head, may also occur.[4][5]

• In some cases, there may be muscle spasms in the neck and shoulders.[6]

Advanced Symptoms:

• If the spinal canal narrows and presses on nerve roots or the spinal cord, more severe symptoms can arise.[7]

• These can include tingling, numbness, and weakness in the arms, hands, legs, or feet.[1]

• Patients may experience a lack of coordination and difficulty walking, sometimes described as a feeling of walking on cotton.[1]

• In severe cases, there can be a loss of bladder or bowel control.[1][7]

• Dizziness and a loss of balance are also possible symptoms.[6]

Causes and Risk Factors

The primary cause of cervical spondylosis is the natural aging process and the associated degeneration of the cervical spine.[1] However, several other factors can contribute to its development and progression:

• Degenerative Disc Disease: As people age, the discs between the vertebrae lose hydration and shrink, leading to more bone-on-bone contact.[1]

• Herniated Discs: Cracks in the exterior of the spinal discs can allow the soft inner material to bulge out and press on the spinal cord and nerve roots.[1][7]

• Bone Spurs: The body may produce extra bone in an attempt to strengthen the spine, but these bone spurs can sometimes pinch the spinal cord and nerves.[1]

• Stiff Ligaments: The ligaments that connect the spinal bones can stiffen with age, reducing neck flexibility.[1]

• Chronic Strain: Repetitive neck motions, awkward positioning, and certain occupations that place a lot of strain on the neck can increase the risk of developing cervical spondylosis.[6]

• Previous Neck Injuries: A history of neck injuries can also be a contributing factor.[6]

• Lifestyle Factors: Smoking, obesity, and a lack of physical exercise are also considered risk factors.[7]

• Genetics: Some genetic factors that affect bone development can also increase susceptibility.[3][7]

Serious Complications

If left untreated or if the condition progresses, cervical spondylosis can lead to a number of serious complications:

• Cervical Radiculopathy: This occurs when a nerve root in the neck is pinched, leading to pain, numbness, or weakness that radiates down the arm.[4][8]

• Cervical Myelopathy: This is a more serious condition where the spinal cord is compressed, which can result in significant neurological problems, including difficulty with coordination and walking, and in severe cases, paralysis.[4][8]

• Chronic Pain: Persistent and debilitating neck pain can significantly impact a person’s quality of life.[6]

• Reduced Mobility: Stiffness and pain in the neck can limit the range of motion, making it difficult to perform daily activities.[9]

• Vertebrobasilar Insufficiency: In some cases, bone spurs can press on the vertebral arteries, which supply blood to the brain. This can lead to dizziness, vertigo, and in rare instances, stroke.

Diagnosis

Diagnosing cervical spondylosis typically involves a physical examination and a review of the patient’s medical history.[4] The doctor may check for neck flexibility, muscle strength, and reflexes.[4] Imaging tests are often used to confirm the diagnosis and assess the extent of the damage:

• X-rays: Can show abnormalities in the bones, such as bone spurs and narrowing of the disc space.[10]

• MRI (Magnetic Resonance Imaging): Provides detailed images of the soft tissues, including the spinal discs and nerves, and can reveal herniated discs or a pinched nerve.[10]

• CT (Computed Tomography) Scan: Can provide more detailed images of the bones than a standard X-ray.[10]

Treatment Options

Treatment for cervical spondylosis focuses on relieving pain, maintaining normal activities, and preventing permanent injury to the spinal cord and nerves.[11]

Western Medicine Approaches:

• Medications: Over-the-counter pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and in some cases, prescription medications may be used to manage pain and inflammation.[11]

• Physical Therapy: Exercises to stretch and strengthen the neck and shoulder muscles can help relieve pain and improve flexibility.[11]

• Traction: This involves gently stretching the neck to help relieve pressure on the spinal discs and nerve roots.[12]

• Injections: Steroid injections can be used to reduce inflammation and relieve pain.[11]

• Surgery: In severe cases where conservative treatments fail or if there are signs of neurological damage, surgery may be recommended to remove bone spurs or parts of a herniated disc to relieve pressure on the spinal cord and nerves.[11]

Traditional Chinese Medicine (TCM) Approaches:

• Acupuncture and Moxibustion: These techniques are used to stimulate specific points on the body to improve the flow of Qi and blood, which can help to relieve pain and muscle tension.[13]

• Tui Na (Manual Therapy): This involves massage and manipulation techniques to relax muscles, improve circulation, and restore the normal alignment of the spine.[13]

• Herbal Medicine: Various herbal formulas are used to address the underlying imbalances that are believed to contribute to cervical spondylosis in TCM, such as dispelling wind and cold, invigorating blood circulation, and nourishing the liver and kidneys.[13]

Prevention and Self-Care

While it may not be possible to completely prevent cervical spondylosis, there are steps that can be taken to reduce the risk and manage the symptoms:

• Maintain Good Posture: Be mindful of your posture, especially when sitting for long periods.

• Ergonomics: Adjust your workstation to ensure that your computer screen is at eye level and that your chair provides adequate support.

• Regular Exercise: Engage in regular physical activity to strengthen the muscles in your neck and back.

• Avoid Neck Strain: Be careful when lifting heavy objects and avoid activities that put excessive strain on your neck.

• Proper Sleep Position: Use a pillow that supports the natural curve of your neck.

• Stay Hydrated: Drink plenty of water to help keep your spinal discs hydrated.

By understanding the causes, symptoms, and treatment options for cervical spondylosis, individuals can take proactive steps to manage the condition and maintain a good quality of life.